1. I've finally managed to get my iron panel results (second time of trying) and the results are as follows:
All in range:
Iron 16
TIBC 64.5
UIBC 48.5
Out of range:
Transferrin saturation 24.8
Ferritin 13.4
So from what I gather from reading everyones amazing advice on this forum is that I should try to raise my ferritin levels by diet more than supplements. My iron is only just in range, so would it be ok to take iron supplements as well as dietary additions (chicken liver pate etc)? The doctor has prescribed 200mg ferrous sulfate. What are people's feelings on this type of iron? Would an iron supplement such as iron bisglycinate be better?
2. And secondly I have a question regarding TSH levels. I've only just started on levothyroxine again after trying to go without it for 2 years. Just before I restarted it, my TSH was measured as high as 41. My next blood test was after being on the levothyroxine for 3 weeks and my TSH has dropped to 3.35! Is such a large and quick drop normal?!!!
Thanks so much in advance!
Gem x
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Cybob
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Sorry! I didn't think that through! I'll put the range in brackets.
Iron 16 umol/L (10-30)
TIBC 64.5 umol/L(45-81)
UIBC 48.5 umol/L(13-56)
Out of range:
Transferrin saturation 24.8% (25-45)
Ferritin 13.4 ug/L(30-207)
Glad to hear that the TSH drop is normal. I will endeavour to get it lower. You recommended a higher dose of Levothyroxine, but I've only been on my the drug for three weeks. Do you not think it will continue to fall? Or do you think it will have plateaued already?
I've spoken on a previous post about my vitamins and minerals, my vit D was deficient.
I'm now supplementing a B complex with folate, Vit D, magnesium, a product called T Convert from Nutri Advanced and now the iron sulfate from the doctor.
What are your thoughts on the iron sulfate if you don't mind?
Sorry I didn't clock that you have only been back on Levo for 3 weeks. Its a little too soon to be testing! It takes a full 6-8 weeks before the dose stabilises and even after that there can be further changes as it 'settles'.
Was there are reason you tested after only 3 weeks?
Suggest you restest after you have been on that dose for a full 6 weeks and post your results then in a new post.
Your supplements look OK if they are the right ones and have enough of each vitamin to raise your level to optimal. Retest vitamins after 3 months.
Some people do OK with GP prescrbed iron, some don't tolerate it well and for some it doesn't work. Remember that raising iron is a slow job whatever supplement you take.
Always take iron 4 hours away from Levo or any other meds/supplements as it affects absorption.
Take iron with orange juice or vit C to help it absorb.
Retest iron in 3-4 months to see how you are doing and assess how well the supplement is working.
According to your iron panel you have room to supplement iron, also your ferritin is very low.
The reason behind the three week test was simply because the consultant took so long to send my prescription and all the tests were booked in! So it was definitely a bit soon. I got a few other things done at the same time to make it worthwhile and I'll definitely retest in 3 - 5 weeks.
I brought up the TSH drop because I thought such a large drop was alarming! But hopefully its ok.
Your vitamin levels will be low as direct result of stopping levothyroxine/being hypothyroid
Ferritin is deficient
GP should be prescribing iron supplements. Have they?
And essential to test vitamin D, folate and B12 as well
What vitamin supplements are you taking
How much levothyroxine are you currently taking
Which brand
Retest after 6-8 weeks including Ft4 and Ft3
Recommended that all thyroid blood tests early morning, ideally just before 9am, only drink water between waking and test and last dose levothyroxine 24 hours before test
This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip)
So yes the doctor has prescribed 200mg of iron sulphate but I wasn't sure if another form might be more effective such as iron bisglycinate?
I'm now supplementing a B complex with folate, Vit D, magnesium glycinate (all researched and planned thanks to your advice on another post )and a product called T Convert from Nutri Advanced.
Ferrous sulphate is the cheapest form of iron that the NHS can prescribe. It is also the least well tolerated and causes lots of stomach/gut problems.
The iron supplements that the NHS prescribes can all be bought in UK pharmacies without a prescription. So if the sulphate is unhelpful or isn't tolerated you are free to buy your own of a different kind.
This link is rather out of date (because doses of iron supplements have been reduced), but it might give you some idea of your options :
Personally, if I was starting to raise my iron now I wouldn't use any of the iron salts in my first attempts. I would try heme (or haem) iron supplements instead :
Take vitamin C with your iron supplements - whatever you choose to take. Some people find it helps absorption of the iron. It can also reduce the risk of becoming constipated. a common issue when supplementing with iron. If you do get constipated with iron increase your dose of vitamin C.
...
Anyone taking iron supplements of any kind will often have no idea how fast their ferritin and/or serum iron will increase - so they need to find out by testing. Speed of absorption varies tremendously between supplements and between people. In the first few months of supplementation regular testing (every 4 - 6 weeks) is essential so that you can adjust dose or stop supplementing if/when your iron /ferritin get to the level you want. If your absorption is poor then you might be able to reduce the frequency of your testing.
Doctors rarely test anything other than ferritin (iron stores). Ferritin is obviously important, but serum iron is equally important. One problem that some people have is that their ferritin might stay low while their serum iron is rocketing upwards. This is not a good result. Excessive amounts of free iron in the bloodstream can end up being deposited in organs including the brain because the body can't get rid of it easily. There are ways around this problem which work for some people. See this explanation :
have a look at nano iron . My results are worse than yours and I’m about to try it. Ferrous sulphate is not easily absorbed, ferrous fumarate will be a bit better though both wreck the gut unfortunately.
Kari55 Have you started the nano iron? I'm curious to see how you get on, it seems to be an expensive way to get the iron in, but maybe it's worth it to start off with
I was wondering whether you had any advice on safe dosages for iron supplements?
I want to replace my ferrous sulphate 200mg prescription for iron bisglycinate (which I have in 40mg pills). I have read that the bisglycinate is twice as available in comparison to the sulphate, so in theory I could use 2.5 tablets to make a direct swap. What confuses me is that the recommended iron intake for a woman of my age is just 14.8mg per day!
Recommended daily for a euthyroid person is probably around 15-20 a day. Consider that we will generally only absorb about 10% thereabouts of whatever iron we take (by food or pill) - that’s based on the fact that we generally shed about 2-4 mg of iron a day (more when on our periods.) So that amount is intended to be a maintenance dose for non-deficient/anemic people.
If you are not a vegetarian, the overwhelming advice you will get here is to consume heme iron, which absorbs 3x better than non heme than those salts, with no vit C requirement, no restrictions of taking with or without food, and no stomach upset. Three Arrows is the brand many of us use and swear by on this forum.
But to answer your question, converting the different salts can be confusing, for example, among other helpful information in this article - healthunlocked.com/redirect... - is this comparison table (at bottom of post)
Iron preparations generally contain one of three iron salts: iron sulphate, iron gluconate, and iron fumurate. It is important to realize, however, that a tablet of the sulfate salt contains twice the amount of iron as a tablet of the other two salts, although the differing molecular weights of the compounds obscure this fact (Table 3). Therefore, twice as many ferrous gluconate or ferrous fumurate tablets are required to provide the amount of elemental iron in ferrous sulfate tablets.
You should be comparing elemental iron, as it’s not the same as the molecular weight. I don’t have info on bisglycinate, but the complicated math will be the same : )
The article above also gives broad and good NIH guidelines for standard iron amemia treatment.
The only thing I will reiterate is that if you supplement, then due to the permanent organ damage that results from iron that is too high (regardless of ferritin), you must commit to early and frequent testing to learn how your own body absorbs iron (everyone is so different, you can rely on anyone else’s numbers).
Your iron is not rock bottom, 30% through range when you should aim for 55-70% through range. On heme iron supplements my daughter went from 0% to over 100% in 5-6 weeks. Some will stay the same or drop. So be consistent with supplements and calibrate accordingly in 4-8 weeks depending on how much you decide to take.
Lastly, your saturation number is another indication that you are only slightly under but not terrible. That number needs to be within range for your T3 to have the iron it needs to do its job. You’re just about in range, but have some room to improve. With this one too - you don’t want to go above out of range.
Thank you FallingInReverse that was very helpful. I've gone through my test results and that paper you linked to and worked out a strategy. I'll concentrate on getting red meat in as regularly as possible but I'll also supplement with the bisglycinate because I'm not always able to prepare food for every meal. Fingers crossed my next test will see improvements 😁
You can only get the Three Arrows product from the USA. Link (and much else) by following this link.
helvella - Iron Document
This is a summary of what I have read up and found out about iron supplements over the past few years. I am not in any way medically trained. You are strongly encouraged to check every detail before making any decisions for yourself.
Content on HealthUnlocked does not replace the relationship between you and doctors or other healthcare professionals nor the advice you receive from them.
Never delay seeking advice or dialling emergency services because of something that you have read on HealthUnlocked.
)and a product called T Convert from Nutri Advanced.
T4 and T3 levels dropping
Iron levels and testing
TSH Dropping on 50mcg Levothyroxine
Blood results- thyroid and iron levels.
TSH drop is it too soon?
